Provider Demographics
NPI:1740860964
Name:ROMEO, MICHAEL (APRN, AGNP, PMHNP)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:ROMEO
Suffix:
Gender:
Credentials:APRN, AGNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 1ST AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-8607
Mailing Address - Country:US
Mailing Address - Phone:727-350-1234
Mailing Address - Fax:727-350-1235
Practice Address - Street 1:3000 1ST AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-8607
Practice Address - Country:US
Practice Address - Phone:727-350-1234
Practice Address - Fax:727-350-1235
Is Sole Proprietor?:No
Enumeration Date:2021-04-12
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11015200363LP0808X, 363LP2300X, 363LA2200X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL115434300Medicaid